(LB01-03-26) Watermelon Consumption and Cardiometabolic Health Outcomes in U.S. Adults: Evidence From a Nationally Representative Survey

Objectives: We hypothesized that higher watermelon consumption frequency would be inversely associated with systolic and diastolic blood pressure (SBP, DBP), LDL cholesterol, triglycerides, fasting glucose, hemoglobin A1c (HbA1c), and insulin resistance in U.S. adults.

Methods: We conducted a cross-sectional analysis using NHANES 2003-2006 data (N = 3,914). HbA1c (n = 3,789), a fasting subsample (n = 1,726) was used for fasting glucose, LDL cholesterol, triglycerides, and HOMA-IR analyses. Watermelon consumption was categorized via food frequency questionnaire into three groups: less than 1 time per week (reference group), 1 to 4 times per week, and 5 or more times per week (N = 2,509 ( < 1 time/week), 936 (1-4 times/week, 469 (5 or more times/week)). Survey-weighted linear regression models were fit across three adjustment levels: unadjusted; minimally adjusted (age, sex, race/ethnicity); and fully adjusted (additionally: BMI, smoking status, physical activity, alcohol intake, sodium, and total energy intake). Stratified analyses were conducted by sex and BMI category.

Results: Consuming watermelon 1 to 4 times per week versus the reference group was associated with lower triglycerides in unadjusted (β = -11.3 mg/dL; 95% CI: -22.5, -0.1) and minimally adjusted models (β = -10.8; 95% CI: -21.3, -0.3), and with lower HOMA-IR across all models (unadjusted: β = -0.56 [-0.89, -0.22]; minimally adjusted: β = -0.49 [-0.81, -0.16]; fully adjusted: β = -0.37 [-0.67, -0.05]). Consuming watermelon 5 or more times per week was associated with lower LDL cholesterol in minimally adjusted (β = -7.7 mg/dL; 95% CI: -12.8, -2.6) and fully adjusted models (β = -6.3; 95% CI: -12.4, -0.1), but with higher SBP (β = +4.1 mmHg; 95% CI: 1.5, 6.7) and higher HbA1c (β = +0.10%; 95% CI: 0.02, 0.18) in unadjusted models only; both associations were attenuated after covariate adjustment, suggesting confounding by lifestyle factors.

Conclusions: Higher watermelon consumption was associated with lower triglycerides, reduced insulin resistance, and lower LDL cholesterol, with associations persisting after full covariate adjustment; these findings are consistent with a potential role for watermelon in cardiometabolic health and support evidence-based dietary recommendations highlighting watermelon as an accessible whole-food intervention

Funding Sources: National Watermelon Promotion Board